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Respiratory and Cardio > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Distribution of blood pressure

A

Normal distribution

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2
Q

Problems with hypertension management

A

Isn’t discrete population groups of ‘hypertension’ and ‘not hypertension’
Most asymptomatic, treatments have side effects

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3
Q

BP can be adjusted by producing changes in the following variables =

A
  • Cardiac output/stroke volume
  • Blood volume
  • HR
  • Resistance to blood flow
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4
Q

2 types of receptors that input into CVS

A
  1. Baroreceptors

2. Chemoreceptors

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5
Q

Baroreceptors found in =

A

Carotid sinus
Aortic arch
Right atrium

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6
Q

Chemoreceptors found in =

A

Carotid bodies

Aortic bodies

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7
Q

Systems which control BP

A

Cardiovascular system

Renal system

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8
Q

Effects of angiotensin II

A

Vasoconstriction

Aldosterone release

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9
Q

Where is aldosterone released from?

A

Adrenal cortex

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10
Q

Effects of aldosterone

A

Increase Na+/H2O retention

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11
Q

Effects of adrenaline and noradrenaline =

A

Increase HR
Increase contractility
Vasoconstriction

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12
Q

AHD effects =

A

Retain H2O

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13
Q

ANP stands for

A

Atrial natriuretic peptide

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14
Q

ANP is released from

A

Atria

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15
Q

Effects of ANP =

A

Lowers flood pressure. Vasodilation, stimulating kidneys to secrete more H2O and Na+

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16
Q

NO is released by

A

Endothelial cells

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17
Q

NO causes

A

vasodilation

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18
Q

Effects of nicotine =

A

Increase BP, stimulate sympathetic neurones

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19
Q

Effects of alcohol =

A

Lowers BP by inhibiting ADH

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20
Q

90-95% of patients with hypertension have

A

Essential/primary hypertension

21
Q

Early stages of essential hypertension =

A

Higher than normal cardiac output/blood volume

22
Q

Chronic stages of essential hypertension =

A

Blood volumes/cardiac output normal.

Increased systemic vascular resistance

23
Q

What causes increased systemic vascular resistance in chronic essential hypertension?

A

Thickening of vessels
Reduced lumen diameter
Increased vascular tone
Reduced NO/reduced sensitivity to NO

24
Q

5-10% of hypertension cases are due to

A

Secondary hypertension

25
Q

Secondary hypertension often has what kind of cause?

A

Endocrine

Renal

26
Q

Ex of renal causes of hypertension

A

Renal artery stenosis

Chronic renal disease

27
Q

Renal artery stenosis =

A

Kidneys are hypoperfused
RAAS system activated
Increased blood volumes, cardiac output, resistance

28
Q

Chronic renal disease is caused by

A

Processes which damage the kidney (e.g. diabetic nephropathy, glomerulonephritis)

29
Q

Chronic renal disease =

A

Reduces Na+/H2O excretion

Increased renin release

30
Q

Examples of endocrine causes of hypertension

A

Conns syndrome

Phaeochromocytoma

31
Q

Conns syndrome also known as

A

primary hyperaldosteronism

32
Q

Causes of Conns syndrome

A

Adrenal tumors

Hyperplasia

33
Q

What happens in Conns syndrome?

A

Increased aldosterone
Na+ and H2) retention
Decreased renin and K+

34
Q

What is decreased in Conns syndrome?

A

Renin:aldosterone

K+

35
Q

A phaeochromocytoma is a

A

Neuroendocrine tumour of the adrenal medulla

36
Q

A phaeochromocytoma secretes

A

Catecholamines

37
Q

Effects of phaeochromocytoma =

A

Alpha mediated vasoconstriction

Beta mediated cardiac stimulation

38
Q

How to diagnose phaeochromocytoma

A

Diagnose 24 hr urinary catecholamines

39
Q

What is a coarctation of the aorta?

A

Aortic narrowing

40
Q

What causes coarctation of the aorta?

A

Congential condition - aorta narrowed where ductus arteriosus inserts

41
Q

What occurs in coarctation of the aorta?

A 
Kidneys are hypoperfused
RAAS activated
Upper body hypertension
Lower body normotension
Radialfemoral delay
42
Q

Radiofemoral delay occurs in what condition?

A

Coarctation of the aorta

43
Q

Other causes of secondary hypertension:

A 
Cushings
Thyroid
Pregnancy
Alcohol
Liquorice
44
Q

How does liquorice cause hypertension?

A

Inhibits enzyme which forms cortisone from cortisol - cortisol acts like aldosterone

45
Q

What can happen to the eye in hypertension?

A

Retinopathy/pizza pie

46
Q

What in the eye can be a sign of hypertension?

A

Papilloedema

47
Q

What is accelerated hypertension?

A

A recent significant elevation over baseline blood pressure which is associated with organ damage

48
Q

What does papilloedema indicate?

A

Raised ICP

49
Q

What happens to the brain in accelerated hypertension?

A

Goes over upper limit of autoregulation - arterioles dilate - hyperperfusion - cerebral oedema - hypertensive encepalopathy

Respiratory and Cardio (14 decks)

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